May 31, 2013 — Less-educated white women were more likely to die than
better-educated females from the mid-1990s through the mid-2000s, according to
a new study co-written by a University of Wyoming professor.

Anna Zajacova, a UW
Department of Sociology assistant professor, and Jennifer Karas Montez, the
study’s lead author and a Robert Wood Johnson Foundation Health and Society
Scholar at Harvard University, combined on the project, "Explaining the
Widening Education Gap in Mortality Among U.S. White Women.”

The study, which appears in the June issue of the Journal of
Health and Social Behavior, relied on National Health Interview Survey Linked
Mortality File statistics from 46,744 white women between the ages of 45-84
from 1997-2006.

For several years, growing mortality differences among white
women were known among researchers. Increasing health inequalities were observed
in much of the population, but the mortality trends among white women had a
particularly disturbing feature, Zajacova says.

“The least-educated white women, during the 1980s and 1990s,
began to live shorter lives -- an unprecedented longevity decline that
contradicted a broad, sweeping increase in life expectancies during the 20th
century in most populations,” she says.

Montez and Zajacova found that growing disparities in
economic circumstances and health behaviors -- especially employment status and
smoking habits from various education levels -- accounted for a major portion
of the widening mortality gap. Their research found that social-psychological
factors contributed little to the increasing gap, but economic circumstances
and health behaviors played important roles.

In their study, the two researchers divided the women into
two groups -- females without a high school credential (lower educated) and
women who at least graduated from high school (higher educated). Montez and
Zajacova noted that the odds of dying among the lower-educated white women
group were 37 percent greater than among their higher-educated peers during
1997-2001, and 66 percent greater during 2002-2006.

Zajacova says little research was done in the past to figure
out the disturbing mortality trends among white women. And, in the few
published studies on the topic, researchers tried to explain the trends by
focusing on individual behaviors -- specifically smoking. However, this focus
excluded the broad economic changes in U.S.
society since the 1970s or 1980s, which included growing employment and
income inequalities.

The two researchers wanted to include these broad changes in
examining what was happening to the least-educated women, and not just focus on
their individual behaviors.

“This broader focus is critical if we want to design social
policies to reverse the growing inequalities,” Zajacova says.

The research noted that throughout the 1980s and 1990s,
inequalities by education grew in the United States: Those with less education increasingly had
relatively less stable and lower-paying jobs compared to those with more
education; and smoking was increasingly concentrated among those with the least
schooling.

“These changes occurred for most demographic groups and
resulted in growing health inequalities for the whole population, but they
seemed to impact white women particularly strongly,” Zajacova says. “Among
white women with the least education, an unprecedented trend occurred: They began dying younger. This is contrary to
a century of systematically increasing life spans in most population in most
countries across the globe, an unusual trend that was bound to attract research
and policy attention.”

In their study, the two researchers looked at eight
components of economic circumstances -- employment, occupation, poverty, home
ownership, health insurance and health behaviors, smoking, obesity and alcohol
consumption. They said employment and smoking were by far the most important
contributors to the widening mortality gap.

“How did we see in the data that employment and smoking were
the most important contributors? We knew numerous characteristics of all the
women in the study, such as their marital status, their psychological state,
whether they consumed alcohol, etc.,” Zajacova says.

She adds that the women’s different marital situations or
alcohol use did not have much effect on the mortality trends. However, as their
research took into account the women’s employment status and smoking, the
mortality trends decreased.

“That is, the less-educated women were less likely to be
employed and more likely to smoke than those with more schooling; when we took
this information into account, we explained the growing mortality disparities,”
Zajacova says. “Now, perhaps the question is why these two factors played such
a prominent role. This may be because both employment and smoking happen to be
important for one’s health and longevity. At the same time, the more- versus
less-educated white women became more dissimilar in employment and smoking
patterns over time, so these two important factors increasingly differentiated
the healthier, more-educated white women from the less-educated ones.”

Zajacova and Montez and have known each other for several
years since meeting at the Austin Population Research Center at the University
of Texas.

“When we realized how similar our research interests are, we
began collaborating about a year ago. We found we work great together and have
several projects under way,” Zajacova says.

Before coming to UW in 2009, she was a postdoctoral fellow
at the University of Michigan. Zajacova completed her doctoral degree in
sociology and demography at Princeton University in 2006.

Her field of work at UW focuses on population health, and
among her other research, is studying health inequalities and the obesity
epidemic.